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Backing and Forthing: The Process of Decision Making by Women Considering Participation in a Breast Cancer Prevention Trial

Karen Moore Schaefer
Elisabeth Ladd
Mary Ann Gergits
Lorraine Gyauch
ONF 2001, 703-709 DOI:

Purpose/Objectives: To describe the process of decision making by women considering participation in a breast cancer prevention trial (BCPT).

Design: Qualitative.

Setting/Sample: Twenty-six women considering participation in a BCPT in the Northeastern United States.

Methods: Women were interviewed one or two times over a period of one year, with each interview averaging 40 minutes in length. The grounded theory method was used to collect and analyze the data. In-depth interviews were conducted with each participant. Data were analyzed using the constant comparative method.

Main Research Content: Context, decision making, meaning.

Findings: The core variable of backing and forthing is a nonlinear complex process of decision making that includes reviewing life, wanting to be sure, chancing and deciding within the contexts of fear, view of self in the world, transgenerational issues, and social support.

Conclusions: The process of decision making for women considering participation in a BCPT is complex. Women tend to make decisions based on what is in their heads and hearts. They often are concerned more about others than they are about themselves.

Implications for Nursing Practice: Trust in the provider and active involvement in the process is critical to women making a decision to participate in a BCPT. Decision making is unique for each woman; however, understanding the context, the core variables, and the process will help healthcare providers to support decision making.

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